This document discusses innovation in chronic disease management. It begins by noting the high costs of healthcare in the US and the modern epidemic of chronic diseases. It then outlines Ochsner Health System's creation of a Center for Innovation to develop new care delivery models using emerging technologies. The Center focuses on improving outcomes for conditions like congestive heart failure and hypertension through multi-level interventions targeting patient behaviors and adherence. These include guided decision support, in-depth assessments, inpatient interventions, and remote home monitoring with the goal of reducing readmissions and improving health outcomes.
Population Health Management PresentationCANorfolk
The document discusses population health management (PHM) and its role in supporting integrated care systems (ICS) in the UK. Key points:
- ICSs will be established everywhere by 2021 to integrate primary/specialist care, physical/mental health, and health/social care.
- PHM solutions will help ICSs understand health needs and match NHS services accordingly through data analysis.
- PHM aims to improve population health through proactive, data-driven care that prevents illness and reduces health inequalities.
Recent advances in the evidence base for technology-based behavioral health applications have provided clinicians a better understanding and guidance on the integration of these tools into clinical care. Participants will learn about research findings on current technologies in use in clinical practice, such as audio conferencing, video conferencing, and virtual reality, in addition to tools available for use between patients, such as the use of websites and mobile applications and wearable sensors.
This document discusses the concept of a learning healthcare system where each patient experience contributes to the evidence base to continuously improve care. It notes that an ideal system provides up-to-date, unbiased, personalized information to patients when and where they want it. However, two cultural challenges remain - acting under uncertainty and improving transparency and trust between providers, health systems, and patients. The document argues that as an integrated, cooperative system, Group Health is well-positioned to help lead the transition to a true learning healthcare system.
Engines of Success for U.S. Health Reform?
Eric B. Larson, MD, MPHVice President for Research, Group Health Executive Director, Group Health Research Institute
Leveraging Mobile Apps and Digital Therapeutics to Improve Behavioral HealthSpectrum Health System
In this presentation, the top apps and digital therapeutics for behavioral health, with a focus on stress, depression, and anxiety, will be reviewed including a summary of program offerings and patient outcomes. Strategies for embedding digital health programs as complements to traditional behavioral health treatment will be discussed. The design and results of a recent implementation of mobile app prescriptions as part of standard care in 12 clinical areas with 70 plus prescribing providers will be described. Engagement and acceptability data from patients and providers will be shared. Strategies for developing standard work and governance for this new category of behavioral health treatment will be offered. Discussion will center on how mobile health represents a high value, low-cost care transformation for the future of health care.
HXR 2016: Which Comes First: Overeating or Obesity? -Dr. David Ludwig, Boston...HxRefactored
The conventional approach to weight loss, based on the calorie balance model, offers the simple advice, “eat less and move more.” Unfortunately, few people can maintain weight loss over the long term through calorie restriction because the body fights back, with rising hunger and slowing metabolism. An alternative approach to treatment aims to target the underlying driver of weight gain – fat cells overstimulated to hoard too many calories – leading to weight loss with less struggle.
This document provides an overview of population health management strategies and tools. It discusses delivering benefits from one website, engaging employees, simplifying benefits delivery, and improving satisfaction. It also outlines problems with traditional benefits delivery and how population health management can help address these issues through outcomes-based wellness incentives, modifiable risk factor reporting, and lifestyle risk calculators that correlate behavior costs to retirement health. The document contains proprietary information for brokers and employers.
Population Health Management PresentationCANorfolk
The document discusses population health management (PHM) and its role in supporting integrated care systems (ICS) in the UK. Key points:
- ICSs will be established everywhere by 2021 to integrate primary/specialist care, physical/mental health, and health/social care.
- PHM solutions will help ICSs understand health needs and match NHS services accordingly through data analysis.
- PHM aims to improve population health through proactive, data-driven care that prevents illness and reduces health inequalities.
Recent advances in the evidence base for technology-based behavioral health applications have provided clinicians a better understanding and guidance on the integration of these tools into clinical care. Participants will learn about research findings on current technologies in use in clinical practice, such as audio conferencing, video conferencing, and virtual reality, in addition to tools available for use between patients, such as the use of websites and mobile applications and wearable sensors.
This document discusses the concept of a learning healthcare system where each patient experience contributes to the evidence base to continuously improve care. It notes that an ideal system provides up-to-date, unbiased, personalized information to patients when and where they want it. However, two cultural challenges remain - acting under uncertainty and improving transparency and trust between providers, health systems, and patients. The document argues that as an integrated, cooperative system, Group Health is well-positioned to help lead the transition to a true learning healthcare system.
Engines of Success for U.S. Health Reform?
Eric B. Larson, MD, MPHVice President for Research, Group Health Executive Director, Group Health Research Institute
Leveraging Mobile Apps and Digital Therapeutics to Improve Behavioral HealthSpectrum Health System
In this presentation, the top apps and digital therapeutics for behavioral health, with a focus on stress, depression, and anxiety, will be reviewed including a summary of program offerings and patient outcomes. Strategies for embedding digital health programs as complements to traditional behavioral health treatment will be discussed. The design and results of a recent implementation of mobile app prescriptions as part of standard care in 12 clinical areas with 70 plus prescribing providers will be described. Engagement and acceptability data from patients and providers will be shared. Strategies for developing standard work and governance for this new category of behavioral health treatment will be offered. Discussion will center on how mobile health represents a high value, low-cost care transformation for the future of health care.
HXR 2016: Which Comes First: Overeating or Obesity? -Dr. David Ludwig, Boston...HxRefactored
The conventional approach to weight loss, based on the calorie balance model, offers the simple advice, “eat less and move more.” Unfortunately, few people can maintain weight loss over the long term through calorie restriction because the body fights back, with rising hunger and slowing metabolism. An alternative approach to treatment aims to target the underlying driver of weight gain – fat cells overstimulated to hoard too many calories – leading to weight loss with less struggle.
This document provides an overview of population health management strategies and tools. It discusses delivering benefits from one website, engaging employees, simplifying benefits delivery, and improving satisfaction. It also outlines problems with traditional benefits delivery and how population health management can help address these issues through outcomes-based wellness incentives, modifiable risk factor reporting, and lifestyle risk calculators that correlate behavior costs to retirement health. The document contains proprietary information for brokers and employers.
The Paradigm Shift from Healthcare to Population HealthPractical Playbook
This document discusses the need to shift from a healthcare system focused on treatment of illness to a population health system focused on preventative care. It notes rising healthcare costs in the US and projections that Medicare and Medicaid will consume all tax revenue by 2050 without reforms. The document outlines Trinity Health's vision of building a "people-centered health system" through initiatives in population health management, care management, and addressing social determinants of health. It provides examples of Trinity Health's work in accountable care organizations, bundled payments, and community engagement initiatives.
Rethinking Value Based Healthcare
Around the world healthcare providers are busy exploring how value-based healthcare can both improve the efficiency and effectiveness of healthcare delivery and seed new opportunities for innovation. Continuing our collaboration with Denmark, we are very pleased to release a new perspective on how VBHC can have greater impact in practice. Based on insights from a recent event hosted by DTU Executive Business Education and undertaken in partnership with Rethink Value, this point of view looks at the key issues for patients, physicals, providers and payers.
It explores some of the associated implications for healthcare systems worldwide, highlights several leading early examples of VBHC in practice and looks at how it can have impact at scale. Recommendations focus on the structure of care, key metrics, moving beyond pilots, changes in reimbursement models and the need for greater insight sharing and deeper collaboration.
For related Future Agenda research see www.futureofpatientdata.org
This presentation offers critical insights on thinking and acting on health equity.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Into the Great Wide Open: Introduction to Telemental Health PracticeSpectrum Health System
This document provides an introduction to telemental health, including definitions of key terms, a brief history, efficacy research findings, opportunities and challenges, best practices, and legal/ethical considerations. The agenda covers synchronous and asynchronous communication, opportunities and challenges of telemental health, familiarity with the practice, and understanding ethical and legal issues. Case vignettes are also presented and discussed.
Patient Directed Care; Why it’s important and what does it really mean?Spectrum Health System
Understanding the importance of effective patient centered communication for patient engagement and improved health outcomes. Will discuss the importance of patient directed care and its relationship to the quadruple aim. Will discuss the barriers and a framework for conversations that are critical to patient directed care and cultural competency.
Dave deBronkart came to focus on participatory healthcare after being diagnosed with stage IV kidney cancer in 2007. Through online research and connecting with other patients, he learned about an immunotherapy treatment that significantly extended his survival, whereas his doctors had given him only a few months to live. This experience led him to become an advocate for empowering patients through technology and social media. He argues that empowered, engaged patients who actively manage their own healthcare can help doctors spend more time with each patient and potentially achieve better health outcomes.
This document provides an overview of integrated health care, including definitions, reasons for its importance, elements of successful models, and challenges. In 3 sentences: Integrated health care combines physical and mental health services to provide coordinated care through programs that address things like chronic conditions, health education, and care for complex multi-morbidities common to those with serious mental illness. Barriers to integration include differing clinical approaches between specialties, lack of provider training, financial and legal issues, and cultural differences between specialties. The benefits of integration include improved detection and treatment of health issues, better outcomes, increased adherence to care, and higher patient and provider satisfaction.
Population Health Management: Where are YOU?Phytel
This presentation explains how population health is fundamental to value-based delivery models, including key principles and definitions of PHM, as well as how to assess your organization’s “population health readiness.”
Navigating the Brain/ Mind Innovation Landscape & Book presentation El Cerebr...SharpBrains
Navigating the Brain/ Mind Innovation Landscape & Book presentation El Cerebro Que Cura (The Brain That Heals)
By Alvaro Fernandez, CEO and Editor-in-Chief at SharpBrains
Slidedeck supporting presentation and discussion during the 2019 SharpBrains Virtual Summit: The Future of Brain Health (March 7-9th). Learn more at:
https://sharpbrains.com/summit-2019/
This document provides an overview of Paul Grundy, the president of the Patient Centered Primary Care Collaborative, and his work promoting the patient centered medical home model. It summarizes his extensive experience and leadership in primary care transformation. It also briefly outlines some of the key principles of the patient centered medical home approach, including comprehensive and coordinated care, enhanced access, quality improvement, and a focus on populations rather than just individual visits. The evidence presented suggests that the medical home model can reduce costs while improving outcomes through lower utilization of emergency rooms, hospitals, and specialty care.
This document provides a framework for improving collaboration between primary care and mental health services globally. It takes a three-step approach:
1. Identifying mental health services that can be delivered in primary care settings by primary care providers, with or without support from mental health professionals.
2. Outlining ways that effective collaboration can enhance primary mental health care, such as integrating mental health services within primary care settings or coordinating care when services are separate.
3. Examining system changes needed to support new roles and activities, and how collaboration can help address challenges facing all mental health systems.
This document discusses value-based care for home healthcare providers. It defines value-based care as outcomes that matter most to patients divided by the total cost of care. This framework helps healthcare providers collaborate to maximize value for patients over their entire care cycle by measuring outcomes and costs in order to iterate and improve over time. Key aspects of implementing value-based care for home health providers include organizing care around patient conditions, measuring outcomes and costs for each patient, enabling integrated technology, and moving to bundled payments for full care cycles.
An overview of the Initial Design and Prize Guidelines for a proposed $10M+ Healthcare X PRIZE, released for public comment on April 14, 2009. Please help us design the best competition possible in creating an Optimal Health paradigm that engages and empowers individuals and communities in a way that will dramatically improve health value.
Improving the Health of Adults with Limited Literacy: What's the Evidence?Health Evidence™
Health Evidence, in partnership with the National Collaborating Centre for Determinants of Health (NCCDH), hosted a 60 minute webinar, funded by the Canadian Institutes of Health Research (KTB-112487), on interventions to improve the health of adults with limited literacy, presenting key messages, and implications for practice on Wednesday October 31, 2012 at 1:00 pm EST. Maureen Dobbins, Scientific Director of Health Evidence, lead the webinar, which included interactive discussion with Karen Fish, Knowledge Translation Specialist, and Connie Clement, Scientific Director, both from the NCCDH.
This webinar focused on interpreting the evidence in the following review:
Clement, S., Ibrahim, S., Crichton, N., Wolf, M., Rowlands, G. (2009). Complex interventions to improve the health of people with limited literacy: A systematic review. Patient Education & Counseling, 75(3): 340-351.
This presentation was presented online by Dr.Vinothini as a part of PG Seminar Presentation and the full video presentation can be found in official YouTube channel of IAPSM eConnect
Link for the video: https://www.youtube.com/watch?v=eqR1J9jjCgs
Promoting Healthy Employees - Embrace the technology !Bernie McCann
This free webinar, sponsored by Screening for Mental Health looks at the importance of including mental health aspects in a workplace wellness approach and features examples from two work organizations which have embraced technology to encourage employees in healthier lifestyles.
The document discusses disease burden and chronic disease management in India. It notes that non-communicable diseases like cardiovascular disease, COPD, asthma and diabetes remain major causes of morbidity. The disease burden from these conditions is projected to increase significantly by 2015. Effective chronic disease management requires sharing health information electronically through a health information exchange. However, convincing stakeholders to share data on a cloud is a major challenge. Personalized, convenient care that blends high-tech and high-touch approaches may help drive behavioral changes needed for successful disease management.
Dr John Wren
Principal Researcher Advisor
New Zealand Accident Compensation Corporation
PO Box 242, Wellington, New Zealand
john.wren@acc.co.nz
(P23, Thursday 27, Civic Room 3, 1.30)
Presentation - The Future of Home HealthC Sam Smith
"Instead of it being described as home healthcare, in a few years the services performed by home health care agencies will simply be known as "modern healthcare".
-Dr. Steve Landers, VNA Health Group, New Jersey
This document summarizes a presentation about building market share through employed physician engagement at Ozarks Medical Center. It describes how OMC recruited specialists but physicians operated independently. A physician council was formed to improve culture and processes, identify barriers to referrals, and standardize protocols. Studies found referral delays in some specialties. Changes improved access and patient satisfaction. Market share increased from 44.1% to 54.5% from 2008 to 2012 after employing physicians and aligning culture and processes.
The perfect health system - Dr Mark BritnellNuffield Trust
At the first keynote for the Nuffield Trust Health Policy Summit 2016, Mark Britnell gives an overview of key characteristics of effective health systems.
The Paradigm Shift from Healthcare to Population HealthPractical Playbook
This document discusses the need to shift from a healthcare system focused on treatment of illness to a population health system focused on preventative care. It notes rising healthcare costs in the US and projections that Medicare and Medicaid will consume all tax revenue by 2050 without reforms. The document outlines Trinity Health's vision of building a "people-centered health system" through initiatives in population health management, care management, and addressing social determinants of health. It provides examples of Trinity Health's work in accountable care organizations, bundled payments, and community engagement initiatives.
Rethinking Value Based Healthcare
Around the world healthcare providers are busy exploring how value-based healthcare can both improve the efficiency and effectiveness of healthcare delivery and seed new opportunities for innovation. Continuing our collaboration with Denmark, we are very pleased to release a new perspective on how VBHC can have greater impact in practice. Based on insights from a recent event hosted by DTU Executive Business Education and undertaken in partnership with Rethink Value, this point of view looks at the key issues for patients, physicals, providers and payers.
It explores some of the associated implications for healthcare systems worldwide, highlights several leading early examples of VBHC in practice and looks at how it can have impact at scale. Recommendations focus on the structure of care, key metrics, moving beyond pilots, changes in reimbursement models and the need for greater insight sharing and deeper collaboration.
For related Future Agenda research see www.futureofpatientdata.org
This presentation offers critical insights on thinking and acting on health equity.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Into the Great Wide Open: Introduction to Telemental Health PracticeSpectrum Health System
This document provides an introduction to telemental health, including definitions of key terms, a brief history, efficacy research findings, opportunities and challenges, best practices, and legal/ethical considerations. The agenda covers synchronous and asynchronous communication, opportunities and challenges of telemental health, familiarity with the practice, and understanding ethical and legal issues. Case vignettes are also presented and discussed.
Patient Directed Care; Why it’s important and what does it really mean?Spectrum Health System
Understanding the importance of effective patient centered communication for patient engagement and improved health outcomes. Will discuss the importance of patient directed care and its relationship to the quadruple aim. Will discuss the barriers and a framework for conversations that are critical to patient directed care and cultural competency.
Dave deBronkart came to focus on participatory healthcare after being diagnosed with stage IV kidney cancer in 2007. Through online research and connecting with other patients, he learned about an immunotherapy treatment that significantly extended his survival, whereas his doctors had given him only a few months to live. This experience led him to become an advocate for empowering patients through technology and social media. He argues that empowered, engaged patients who actively manage their own healthcare can help doctors spend more time with each patient and potentially achieve better health outcomes.
This document provides an overview of integrated health care, including definitions, reasons for its importance, elements of successful models, and challenges. In 3 sentences: Integrated health care combines physical and mental health services to provide coordinated care through programs that address things like chronic conditions, health education, and care for complex multi-morbidities common to those with serious mental illness. Barriers to integration include differing clinical approaches between specialties, lack of provider training, financial and legal issues, and cultural differences between specialties. The benefits of integration include improved detection and treatment of health issues, better outcomes, increased adherence to care, and higher patient and provider satisfaction.
Population Health Management: Where are YOU?Phytel
This presentation explains how population health is fundamental to value-based delivery models, including key principles and definitions of PHM, as well as how to assess your organization’s “population health readiness.”
Navigating the Brain/ Mind Innovation Landscape & Book presentation El Cerebr...SharpBrains
Navigating the Brain/ Mind Innovation Landscape & Book presentation El Cerebro Que Cura (The Brain That Heals)
By Alvaro Fernandez, CEO and Editor-in-Chief at SharpBrains
Slidedeck supporting presentation and discussion during the 2019 SharpBrains Virtual Summit: The Future of Brain Health (March 7-9th). Learn more at:
https://sharpbrains.com/summit-2019/
This document provides an overview of Paul Grundy, the president of the Patient Centered Primary Care Collaborative, and his work promoting the patient centered medical home model. It summarizes his extensive experience and leadership in primary care transformation. It also briefly outlines some of the key principles of the patient centered medical home approach, including comprehensive and coordinated care, enhanced access, quality improvement, and a focus on populations rather than just individual visits. The evidence presented suggests that the medical home model can reduce costs while improving outcomes through lower utilization of emergency rooms, hospitals, and specialty care.
This document provides a framework for improving collaboration between primary care and mental health services globally. It takes a three-step approach:
1. Identifying mental health services that can be delivered in primary care settings by primary care providers, with or without support from mental health professionals.
2. Outlining ways that effective collaboration can enhance primary mental health care, such as integrating mental health services within primary care settings or coordinating care when services are separate.
3. Examining system changes needed to support new roles and activities, and how collaboration can help address challenges facing all mental health systems.
This document discusses value-based care for home healthcare providers. It defines value-based care as outcomes that matter most to patients divided by the total cost of care. This framework helps healthcare providers collaborate to maximize value for patients over their entire care cycle by measuring outcomes and costs in order to iterate and improve over time. Key aspects of implementing value-based care for home health providers include organizing care around patient conditions, measuring outcomes and costs for each patient, enabling integrated technology, and moving to bundled payments for full care cycles.
An overview of the Initial Design and Prize Guidelines for a proposed $10M+ Healthcare X PRIZE, released for public comment on April 14, 2009. Please help us design the best competition possible in creating an Optimal Health paradigm that engages and empowers individuals and communities in a way that will dramatically improve health value.
Improving the Health of Adults with Limited Literacy: What's the Evidence?Health Evidence™
Health Evidence, in partnership with the National Collaborating Centre for Determinants of Health (NCCDH), hosted a 60 minute webinar, funded by the Canadian Institutes of Health Research (KTB-112487), on interventions to improve the health of adults with limited literacy, presenting key messages, and implications for practice on Wednesday October 31, 2012 at 1:00 pm EST. Maureen Dobbins, Scientific Director of Health Evidence, lead the webinar, which included interactive discussion with Karen Fish, Knowledge Translation Specialist, and Connie Clement, Scientific Director, both from the NCCDH.
This webinar focused on interpreting the evidence in the following review:
Clement, S., Ibrahim, S., Crichton, N., Wolf, M., Rowlands, G. (2009). Complex interventions to improve the health of people with limited literacy: A systematic review. Patient Education & Counseling, 75(3): 340-351.
This presentation was presented online by Dr.Vinothini as a part of PG Seminar Presentation and the full video presentation can be found in official YouTube channel of IAPSM eConnect
Link for the video: https://www.youtube.com/watch?v=eqR1J9jjCgs
Promoting Healthy Employees - Embrace the technology !Bernie McCann
This free webinar, sponsored by Screening for Mental Health looks at the importance of including mental health aspects in a workplace wellness approach and features examples from two work organizations which have embraced technology to encourage employees in healthier lifestyles.
The document discusses disease burden and chronic disease management in India. It notes that non-communicable diseases like cardiovascular disease, COPD, asthma and diabetes remain major causes of morbidity. The disease burden from these conditions is projected to increase significantly by 2015. Effective chronic disease management requires sharing health information electronically through a health information exchange. However, convincing stakeholders to share data on a cloud is a major challenge. Personalized, convenient care that blends high-tech and high-touch approaches may help drive behavioral changes needed for successful disease management.
Dr John Wren
Principal Researcher Advisor
New Zealand Accident Compensation Corporation
PO Box 242, Wellington, New Zealand
john.wren@acc.co.nz
(P23, Thursday 27, Civic Room 3, 1.30)
Presentation - The Future of Home HealthC Sam Smith
"Instead of it being described as home healthcare, in a few years the services performed by home health care agencies will simply be known as "modern healthcare".
-Dr. Steve Landers, VNA Health Group, New Jersey
This document summarizes a presentation about building market share through employed physician engagement at Ozarks Medical Center. It describes how OMC recruited specialists but physicians operated independently. A physician council was formed to improve culture and processes, identify barriers to referrals, and standardize protocols. Studies found referral delays in some specialties. Changes improved access and patient satisfaction. Market share increased from 44.1% to 54.5% from 2008 to 2012 after employing physicians and aligning culture and processes.
The perfect health system - Dr Mark BritnellNuffield Trust
At the first keynote for the Nuffield Trust Health Policy Summit 2016, Mark Britnell gives an overview of key characteristics of effective health systems.
This document discusses how Lean principles from manufacturing, originally developed by Toyota, can be applied to healthcare settings to improve quality, efficiency and staff satisfaction. It provides examples from pathology and day surgery departments in the UK where mapping processes identified unnecessary steps and waste. Relocating equipment and redesigning workflows reduced sample processing times from 24-30 hours to 2-3 hours in pathology. Lean implementation typically provides improved safety, timeliness of care, throughput and staff morale by engaging frontline staff. The benefits come in waves as principles become embedded in the organization's culture and ways of working.
Farla Medical, one of the UK's largest supliers of medical technologies, commodities and consumables shared best practices from the UK. Including in infection prevention and control, tooling HRH and improving heath service delivery efficiencies.
This document discusses the potential for electronic data capture in community health research and development. It notes that nurses are becoming major contributors of electronically captured data, but that the data is often interpreted and used in ways removed from its original purpose. It outlines six domains where increased data transparency could impact: accountability, choice, productivity, care quality, social innovation and economic growth. However, it stresses the importance of nurses actively participating in and influencing how this data is captured, interpreted and used.
Data drives company outcomes - employers agree analytics are a key factor in strategic planning. Customizing wellness solutions that has turned science fiction into science. Employees biometrics and genomics - sequencing the genome - drives choosing individualized wellness coaching. Health solutions - providing a path of sustainability and adherence - scientific, engaging, redefining individualized - And we make it affordable. Employee health programs - what a wonderful way to build healthier communities - establish lifestyle habits creating a healthier future for our children. We can manage & prevent chronic illnesses - saving lives and money - investing the money for happier, bigger, better futures.
Running head SKILLS ASSESSMENT PAPER1SKILLS ASSESSMENT PAPE.docxtodd521
Running head: SKILLS ASSESSMENT PAPER
1
SKILLS ASSESSMENT PAPER
4
Skills Assessment Paper
Summary of Skills
For the development of an organization to be successful and effectively achieve set goals and objectives, strong management and organization skills will be required (Bateman & Snell, 2007). Our Team A brings a broad spectrum of skills and talents coming from life, educational and work-related experiences. Each member of the team possesses unique skill sets that will bring fresh ideas, techniques and creative solutions to challenges in the development of our consulting firm.
A thorough evaluation of our team member’s skills, suggests that our key strengths lie within teamwork and dedication, creating presentations, critical thinking, problem-solving techniques, communication, research, and observations. With these skills, this team will be able to successfully achieve most tasks necessary in the development of a consulting firm. This team will need to use these skills to collaborate efforts in a cooperative manner to create, plan, develop and accomplish the goals of the consulting firm. This evaluation also portrays a strong dedication to learning and improving which is beneficial in the development of new skills that may be needed.
Most members of our team currently have educational and professional experience that proves an intense desire to improve and advocate change and educate communities to collaborate an effort enhancing the lives of individuals. This desire will effectively promote positive changes both within communities as well as at a societal level. The team’s overall commitment is to meet basic human needs through education, focusing on identification of challenges and prevention, as well as assist in overcoming personal and organizational obstacles that individuals may face. Our team is committed to improving the overall quality of life through advocacy and action.
The first type of consulting firm that we could possibly work with would be a human services/independent living consulting program. This program would collaborate with a client’s care givers, doctors and independent care organizations to assist in facilitating a client’s independence and improve or maintain health. This consulting firm would collaborate efforts to create an independent, long-term care plan that will enhance the develop of daily living skills, educate on services and programs available, exercise the right to make healthy living choices, and encourage pro-active involvement of all care-giving professionals in the pursuit of personal growth, presence, and participation in the long term care process. This program will improve and emphasis respect and dignity through the promotion of independence.
PLEASE ADD THE OTHER TWO TYPES HERE!
The types of problems these consulting firms might solve.
Inflexible regulatory and legal issues create competitive obstacles human services providers face when offering health services to communities.
The document discusses innovations in healthcare to address issues from aging populations and chronic disease management. It notes rising healthcare costs, a need for improved access to specialists, and resource constraints. New technologies like telemedicine, remote monitoring, and mobile access aim to improve care coordination and empower patients while overcoming barriers. Integrated models of care that seamlessly connect providers, payors, and patients show potential to lower costs and raise quality and satisfaction for chronic care patients.
The document summarizes a presentation on organizing health information in an eHealth environment according to citizen-centric principles and concepts. It outlines the background, methods, preliminary findings, conceptual information model, information management principles, and roadmap presented. The presentation calls for an iterative development process to involve stakeholders and promote a citizen-centric model for integrating new eHealth possibilities in New Zealand's health systems.
Asia HealthTech Investments by Julien de Salaberry (30 June 2015)KickstartPH
Kickstart Ventures' 2nd HealthTech Forum featured Julien de Salaberry, a globally-recognised expert on healthcare and technology.
Julien, the Chief Innovation Officer and Founder of The Propell Group (based in Singapore), talked about healthcare trends in Southeast Asia and how “frugal innovation" can be done in healthcare delivery.
And yeah, if you've got an interesting healthtech startup, message us at info@kickstart.ph. #startupPH
2B Kalfhaus Opportunities and Challenges of Telemedicine EHiN 2014IKT-Norge
Lars Kalfhaus
Country Manager Roche Diabetes Care (ES)
Connect, Engage and Take Decisions
Opportunities and Challenges of Telemedicine Implementation
EHiN 2014, IKT-Norge og HOD
We’re creating a home blood testing device that with one finger prick, tells you:
(1) What your major health indicators are
(2) Whether they’re at healthy levels or not
(3) If they’re problematic, then recommendations on how to improve your health, and the option to send those results to a doctor
Instant and accurate results for you, your family, and those you care about.
Technology will save our minds and bodiesKristynKing
Technology can both help and harm health, but on balance it improves lives. Advances like X-rays and vaccines allow accurate diagnosis and disease prevention. Organ transplants and remote monitoring help save lives and manage conditions. However, medical devices sometimes fail or provide inaccurate information, and many online health sources give wrong advice. Overall, the benefits of medical technology outweigh the risks when properly implemented with oversight.
The document discusses a quality premium program that rewards clinical commissioning groups for improvements in quality and outcomes. It explains that the premium is based on performance on 4 national measures and 3 local measures selected by each CCG. The national measures relate to reducing mortality, emergency admissions, patient experience, and infections. For a sample CCG, emergency admissions are a major issue, with over 56,000 total admissions last year. Selecting local measures that help achieve the national measures, like reducing emergency admissions, could maximize the CCG's quality premium payment.
This document summarizes a presentation on disruptive innovation in healthcare through digital technologies. It discusses how digital technologies have transformed other industries like banking, travel, and research. It then outlines some challenges facing healthcare like rising costs and notes how digital technologies could help address issues like doctor shortages by empowering patients. Examples discussed include online access to health records and data, remote monitoring, automated diagnosis, and social networks for patient communities. The presentation argues that patients are becoming experts in their own health conditions and should have more control over their own health data and management.
This document discusses the potential role of national health insurance in creating a safe, affordable, and high-quality healthcare system in the Bahamas. It begins by outlining the government's vision of transforming healthcare to be the safest and most effective in the region. It then discusses some of the current challenges in the Bahamian healthcare system, including a lack of coordination, increasing costs, and workforce issues. The document also reviews international healthcare system rankings and compares mortality rates between public and private patients in Bahamian hospitals. Overall, the document examines how a national health insurance system could help address issues in the current healthcare system and better serve the needs of Bahamians.
The document discusses an innovative nutritional diagnostic tool called MDflux that allows dietitians and doctors to precisely assess a patient's nutritional state and needs. It found that standard hospital care often results in overfeeding or undernourishment of patients. MDflux provides actionable data to personalize nutrition and support healing. Key learnings included that dietitians are the main stakeholders, there is potential in neonatal care, and a partnership could help scale internationally and obtain regulatory approvals. The total addressable market is estimated at $9 billion annually in the US.
1) The role of health care data analysts is evolving as the volume of available data grows exponentially. With zettabytes of data being generated, analysts must make sense of both structured and unstructured information.
2) Data analytics can provide insights to improve patient outcomes, lower costs, and enhance the health care experience. Examples show how visualizing data helps health systems better understand utilization and identify at-risk patients.
3) As incentives shift from fee-for-service to value-based models, health systems must transform to focus on population health. Advanced analytics and predictive modeling will be crucial to achieving the goals of better care, lower costs, and improved health.
At the frontier of Big Data and Brain HealthSharpBrains
During this session we will explore cutting-edge initiatives to accelerate research & development via Big Data, crowdsourcing, technologies for the extended mind, and a range of data-rich pervasive neurotechnologies such as virtual reality.
-Chair: Alison Fenney, Director of Industry Alliances at the Neurotechnology Industry Organization (NIO)
-Dr. Walter Greenleaf, Distinguished Visiting Scholar at Stanford University’s Virtual Human Interaction Lab
-Michael Meagher, President of Cogniciti
-José Barrios, Co-Founder & CEO of Cognilab
-Dr. Peter Reiner, Co-Founder, National Core for Neuroethics at the University of British Columbia
Presentation @ The 2015 SharpBrains Virtual Summit http://sharpbrains.com/summit-2015/agenda
Chocking the Barriers to Change in Healthcare System.By.Dr.Mahboob ali khan Phd Healthcare consultant
Change is undeniably hard, whether the subject is weight control for an individual or “wait control” in the emergency department. But even though it is easy to come up with excuses for allowing diets or change initiatives to slide, there are measurable rewards for adopting an approach that allows a person or an institution to set the right targets, achieve those goals and stay on track.
Similar to Health IT Summit Miami 2015 - Presentation “Innovation and Chronic Disease Management” (20)
1) Hackensack University Medical Center is part of a large healthcare network in New Jersey serving over 6 million people. It has received numerous awards and recognition for clinical excellence.
2) The presentation discusses HackensackUMC's strategies for managing risk-based care and consumerism, which includes a focus on patient engagement, care coordination across settings, and using technology like EHRs and analytics to improve outcomes and reduce costs.
3) HackensackUMC is managing care for over 100,000 beneficiaries through its Medicare ACO, a Blue Cross ACO, and an Aetna Medicare Advantage plan. It aims to shift care toward prevention and meet the growing demands of consumerism through increased access,
The U.S. healthcare system is the most expensive yet least effective compared to other industrialized nations. While some areas of the U.S. have high quality care, it is not universal. The document discusses leveraging design thinking and positive deviance to spread best practices more widely. It emphasizes starting with a compelling vision, building trust through networks rather than strict workflows, using data to measure important outcomes, and developing skills and resources to build capacity for change. Spreading ideas requires a social as well as scientific approach.
The document discusses Cleveland Clinic's strategy for managing patient populations beyond meaningful use requirements. It provides an overview of Cleveland Clinic including its size and services. It then summarizes the history of Cleveland Clinic's patient portal called MyChart, highlighting growth in usage and new features added over time. Finally, it outlines Cleveland Clinic's growth strategy, which includes increasing transparency by providing access to medical records and surveys, improving access to care through online services, and engaging patients through collection of patient entered data.
Development and implementation of a system to support prediction of suicide risk in the Department of Veterans Affairs - DR. Robert Bossarte and Paul Bradley
The document discusses participatory health care and the need to shift from the current health care system to one focused on health. It notes that the health care problem stems from issues with care delivery design rather than a lack of medical innovation. The Center for Innovation at Mayo Clinic is working to transform health care delivery and the patient experience through human-centered design, collaboration, and rapid experimentation. Some of their projects include connected care apps and redesigning prenatal care to reduce visits and increase patient connectivity. The document advocates for engaging patients in their own health and activating them as partners in health care through tools that provide autonomy, mastery and purpose.
The document discusses Illumina's role in advancing precision medicine through next-generation sequencing and data analytics. It notes that while sequencing costs have decreased dramatically, challenges remain in interpreting, integrating, and analyzing the large volumes of genomic and other healthcare data. Illumina aims to develop comprehensive, patient-centric analytics platforms and knowledgebases to help address these challenges and enable more effective prevention, diagnosis, and treatment based on a patient's genetics, environment, and lifestyle. The success of these efforts will be measured by improvements in patient outcomes, healthcare costs and efficiencies, and changes in clinical practice guided by integrated genomic and clinical data analysis.
This document discusses partnering for success in healthcare IT leadership. It provides strategies for building trusted relationships, embracing change, and shifting the focus from technology management to strategic business partnerships. Approaches include being open, a problem solver, agile, and willing to empower teams and make difficult decisions. The changing role of the healthcare IT leader is also addressed, such as anticipating change, having strong change management skills, and developing a broad industry network to address challenges from resistors. The overall message is that partnership, communication, and adaptability are key for healthcare IT leaders to successfully guide their organizations through a rapidly changing environment.
This document summarizes a presentation about setting vision and strategy for health IT leaders in dynamic times. It discusses exploring new leadership skills required for effective collaboration. It also addresses aligning technology strategies with organizational services and objectives. Additionally, it covers representing the organization to external partners to achieve business goals while leveraging technology. The presentation provides approaches for health IT leaders to develop an organizational vision and strategy that can adapt to changing conditions.
The document discusses developing talent and effective teams in healthcare leadership. It provides tips for leaders such as acting as a role model who embraces learning, celebrating outcomes and learning from assignments, building sustainable processes for development where managers coach their people, and leveraging problems as opportunities for learning. Developing talent requires focusing on culture through employee engagement, rewards and recognition, and building a positive organizational reputation. The presentation was given by Liz Johnson and Geoff Brown at a CHIME leadership forum on developing healthcare talent and teams.
The document discusses top cybersecurity risk mitigation strategies presented at a CHIME Leadership Education and Development Forum. It provides an overview of resources from the Department of Homeland Security and FBI that can help with gathering threat intelligence and establishing situational awareness. It emphasizes that proper user training, monitoring, and access management are important for risk mitigation. It also stresses the importance of the "people factor" and how human awareness and behavior are key to creating an effective human firewall against cybersecurity threats.
This document summarizes a presentation on cybersecurity threats facing healthcare organizations. It discusses how threat actors have evolved tactics like spear phishing and malware to target individuals. The presentation outlines the typical stages of an attack from initial reconnaissance to exfiltration of data. It provides recommendations for technical defenses like multifactor authentication and network segmentation as well as cultural changes like leadership support and security awareness training. Case studies from Emory Healthcare show the types of attacks blocked each month and techniques used to manage risk through frameworks and continuous improvement.
The Internet of Things (IoT) allows physical objects to be connected to the internet and to collect and exchange data. This enables remote monitoring and control of those objects over existing network infrastructure. It creates opportunities to more closely integrate the physical world with information systems, resulting in improved efficiency, accuracy, and economic benefits.
This document summarizes a presentation given by Doug Fridsma on meaningful use and precision medicine. Some key points from the presentation include:
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Sajid Ahmed presented on the implementation of an EHR system at Martin Luther King Jr Community Hospital on a limited budget and tight timeline. The hospital was established through a public-private partnership between LA County and UCLA. Key strategies for successful implementation included aligning the culture, processes and people; allowing the processes to drive the EHR design rather than the other way around; and focusing on the hospital's mission when facing challenges. Through extensive planning and vendor management, the EHR went live on time and on budget to support the hospital's opening.
This document provides an overview of Dignity Health's strategies for achieving Meaningful Use objectives across their large health system. It discusses their centralized governance structure and tools for tracking progress. Significant attention is given to challenging objectives like patient electronic access, summary of care exchange, and public health reporting. The document outlines communication plans, education provided to sites, and techniques for monitoring metrics and preparing strong audit defenses.
The document discusses healthcare leadership and the implementation of electronic medical records (EMRs). It notes that in 1999, the Institute of Medicine reported that medical errors resulted in 44,000 preventable deaths annually in the US. As of 2009, only 1.5% of hospitals and 4% of physician practices had fully implemented EMR systems. The document emphasizes that successful EMR implementation requires focusing on people first by engaging user leaders, getting everyone onboard, and setting clear ground rules. It also stresses the importance of moving quickly with an aggressive schedule, capitalizing on moments of crisis to drive change, and clear communication throughout the process.
THE SACRIFICE HOW PRO-PALESTINE PROTESTS STUDENTS ARE SACRIFICING TO CHANGE T...indexPub
The recent surge in pro-Palestine student activism has prompted significant responses from universities, ranging from negotiations and divestment commitments to increased transparency about investments in companies supporting the war on Gaza. This activism has led to the cessation of student encampments but also highlighted the substantial sacrifices made by students, including academic disruptions and personal risks. The primary drivers of these protests are poor university administration, lack of transparency, and inadequate communication between officials and students. This study examines the profound emotional, psychological, and professional impacts on students engaged in pro-Palestine protests, focusing on Generation Z's (Gen-Z) activism dynamics. This paper explores the significant sacrifices made by these students and even the professors supporting the pro-Palestine movement, with a focus on recent global movements. Through an in-depth analysis of printed and electronic media, the study examines the impacts of these sacrifices on the academic and personal lives of those involved. The paper highlights examples from various universities, demonstrating student activism's long-term and short-term effects, including disciplinary actions, social backlash, and career implications. The researchers also explore the broader implications of student sacrifices. The findings reveal that these sacrifices are driven by a profound commitment to justice and human rights, and are influenced by the increasing availability of information, peer interactions, and personal convictions. The study also discusses the broader implications of this activism, comparing it to historical precedents and assessing its potential to influence policy and public opinion. The emotional and psychological toll on student activists is significant, but their sense of purpose and community support mitigates some of these challenges. However, the researchers call for acknowledging the broader Impact of these sacrifices on the future global movement of FreePalestine.
A Free 200-Page eBook ~ Brain and Mind Exercise.pptxOH TEIK BIN
(A Free eBook comprising 3 Sets of Presentation of a selection of Puzzles, Brain Teasers and Thinking Problems to exercise both the mind and the Right and Left Brain. To help keep the mind and brain fit and healthy. Good for both the young and old alike.
Answers are given for all the puzzles and problems.)
With Metta,
Bro. Oh Teik Bin 🙏🤓🤔🥰
🔥🔥🔥🔥🔥🔥🔥🔥🔥
إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
🔥🔥🔥🔥🔥🔥🔥🔥🔥
How to Manage Reception Report in Odoo 17Celine George
A business may deal with both sales and purchases occasionally. They buy things from vendors and then sell them to their customers. Such dealings can be confusing at times. Because multiple clients may inquire about the same product at the same time, after purchasing those products, customers must be assigned to them. Odoo has a tool called Reception Report that can be used to complete this assignment. By enabling this, a reception report comes automatically after confirming a receipt, from which we can assign products to orders.
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
Temple of Asclepius in Thrace. Excavation resultsKrassimira Luka
The temple and the sanctuary around were dedicated to Asklepios Zmidrenus. This name has been known since 1875 when an inscription dedicated to him was discovered in Rome. The inscription is dated in 227 AD and was left by soldiers originating from the city of Philippopolis (modern Plovdiv).
2. Necessity is the mother of invention.
The Republic, Book II, 369BC, Plato
& innovation
3. Healthcare Spending as a Percent of
Gross Domestic Product
17.7%
11.9%
11.6%
11.2%
9.6%
9.4%
9.3%
9.0%
7.9%
7.7%
7.4%0% 9% 18%
United States
Netherlands
France
Canada
Japan
United Kingdom
OECD Average
Finland
Hungary
Israel
South Korea
Source: OECD. http://www.vox.com/cards/how-doctors-are-paid/how-else-could-the-us-bring-down-health-care-costs#E5744046
4. 3 6 4 1 5 2 7
4 7 5 2 1 3 6
2 7 6 3 5 1 4
6 5 3 1 4 2 7
4 5 7 2 1 3 6
2 5 3 6 1 7 4
6.5 5 3 1 4 2 6.5
6 3.5 3.5 2 5 1 7
6 7 2 1 3 4 5
2 6 5 3 4 1 7
4 5 3 1 6 2 7
1 2 3 4 5 6 7
$3,357 $3,895 $3,588 $3,837 $2,454 $2,992 $7,290
AUS CAN GER NETH NZ UK US
OVERALL RANKING (2010)
Quality Care
Access
Efficiency
Equity
Long, Healthy, Productive Lives
Health Expenditures/Capita, 2007
Cost-Related Problem
Timeliness of Care
Effective Care
Safe Care
Coordinated Care
Patient-Centered Care
Source: The Commonwealth Fund: Mirror Mirror On The Wall: How the Performance of
the U.S. Health Care System Compares Internationally 2010 Update
How the US Health Care System Compares Internationally
5. 600,000
700,000
800,000
900,000
2008 2010 2015 2020
Demand Supply
Projected Supply and Demand,
Physicians (all specialties)
Physician supply not keeping pace with increasing demand for healthcare services
91,500
62,900
Source: AAMC Center for Workforce Studies, June 2010 Analysis
7. Bubonic Plague
1347-1350
>25 Million deaths
30-70% of the Population
Cholera
1817-1860 1865-1900
>50 Million deaths
10% of the Population
Influenza
1918-1919
>75 Million deaths
30-70% of the Population
9. Chronic Disease
75% of U.S. health care dollars goes to treatment of
chronic disease.
Nation’s leading cause of death and disability causing
70% of all deaths.
50% of all adult American have at least one chronic
disease.
90% of seniors have at least one chronic disease, and
77% have two or more chronic conditions.
Median outpatient visit length is < 15 minutes covering a median of 6 topics
Source: Centers for Disease Control and Prevention. http://www.cdc.gov/chronicdisease/index.htm
BMJ 2013;346:f2614. http://transformativehealth.info/a-c-suite-view/patient-engagement-a-strategic-imperative-for-preventing-readmissions/
Tai-Seale M, et al. Health Serv Res. 2007;42:1871-1894. Gottschalk A, et al. Ann Fam Med. 2005;3:488-493.
10. Four Common Causes of
Chronic Disease
Health Behaviors
Lack of physical activity
Poor nutrition
Tobacco use
Excessive alcohol consumption
obesity
• diabetes
• hypertension
• heart failure
• coronary heart disease
• stroke
• cancer
• OSA
• atrial fibrillation
• hyperlipidemia
• gallstones
• back pain
• infertility
• skin infections
• gastric ulcers
Source: http://www.cdc.gov/chronicdisease/overview/index.htm
11. Projected Growth in Population with Chronic Conditions
2013-2025
Dall TM, et al Health Affairs 2013;32:2013-2020.
12. Adherence to Quality Indicators in Chronic Disease
Condition No. of Indicators
% of Recommended
Care Received
Overall Care 439 54.9%
Hypertension 27 64.7%
Heart Failure 36 63.9%
COPD 20 58.0%
Asthma 25 53.5%
Hyperlipidemia 7 48.6%
Diabetes mellitus 13 45.4%
Peptic ulcer disease 8 32.7%
Atrial fibrillation 10 24.7%
McGlynn EA, et al. N Engl J Med 2003;348:2635-45.
13. Last
Costs too high Poor quality
Modern day epidemic Receiving recommended care
Demand outpacing supply
What’s the Necessity?What’s the Necessity?
14. Factors Influencing Health Status
40%
15%
30%
5%
10%
Schroeder SA. N Engl J Med 2007;357:1221-8.
Environmental
exposure
Genetic predisposition
15. Factors Influencing Health Status
Electronic Health Records
Meaningful Use
Core Measures
Transparency
HCAHPS, CAHPS
HEDIS, SCIP
Pay for Performance
PACS
Joint Commission, Leapfrog
40%
15%
30%
5%
10%
Health care
Health care
Schroeder SA. N Engl J Med 2007;357:1221-8.
16. Factors Influencing Health Status
Social Circumstances
Living conditions (live alone)
Transportation
Access to care
Medication affordability
Social network support
Education level
40%
15%
30%
5%
10%
Social
Circumstances
Health care
Schroeder SA. N Engl J Med 2007;357:1221-8.
17. Factors Influencing Health Status
40%
15%
10%
Schroeder SA. N Engl J Med 2007;357:1221-8.
Behavioral patterns
Social
Circumstances
Health care
Behavioral patterns
Depression
Medication adherence
Social network influence
Physician/Health-System perception
Lifestyle: diet, activity
Patient activation
18. Last
Costs too high Poor quality
Modern day epidemic Receiving recommended care
Demand outpacing supply
Not effectively targeting
behavioral patterns
What’s the Necessity?What’s the Necessity?
19. Traditional Innovations Inside Health Systems
Electronic Health Records
Meaningful Use
Core Measures
Transparency
HCAHPS, CAHPS
HEDIS, SCIP
Pay for Performance
PACS
Joint Commission, Leapfrog
Telemedicine
LEAN
20. Concept of an Innovation Team
Our Chief Clinical Transformation officer was leading innovation efforts in these
traditional innovation areas, and this was also my primary focus from an IT
perspective
Internal discussions about creating an innovation team to focus on larger issues in
the industry
Inspiration
• Skunk Works – Total control by manager, restrict access to project to protect the
innovative ideas
• IDEO – Super small teams, informal, no hierarchy, a free flow of ideas, and quick
prototyping
How to pull this off at a Health System?
21. Ochsner Center for Innovation
Created in 2013
Tasked with going above and beyond the typical, incremental optimization of
software systems and clinical workflows
Use the newest technologies to innovate care delivery models
Not just another IT department – use pharmacists, nurses and operational liaisons
to support new programs
Integration into operations and IT is crucial to the long term success and
maintainability of our programs, so we cannot be isolated
• Separate space, but still close to IT
• Open work areas, conference rooms, white boards
22. An Evolving Team Structure
Initial team was made up of volunteers in both IT and operations, two part-time
pharmacists, and myself as the only full-time member.
Technical team met twice a week to develop our programs and divide up work.
Patient care team worked remotely supporting our programs.
As successful projects were implemented, more funding was secured to hire more
full-time team members
To date, we now have funding for 5 full-time team members in addition to the over
10 part-time volunteers participating
25. Partnership with IT
The IT department uses the Center for Innovation to grow their talent and teach
them to think outside of the box
Co-sponsor annual innovation challenges to generate new ideas and interest in the
team
New career path from IT to the Center for Innovation for people who may not want
to become managers
26. Prove Value Quickly
Developing and testing new care delivery models takes time, and we needed to
create value quickly
There were prerequisite foundational systems to build and implement before new
care delivery models could be piloted
Team focused on a couple of key issues to prove value quickly and buy time
• Reimbursement for our capitated population is dependent on physicians billing
HCCs (Hierarchical Condition Categories) once a year
• Inaccurate coding costs us millions in lost revenue for the conditions we treat, so
this is great bang for your buck
27. Prove Value Quickly
The prevalence of morbid obesity is now over 6% of the US population and a brand
new HCC in 2013
Only 18% of qualifying patient visits (BMI>40) contained a visit diagnosis of morbid
obesity in 2012 totaling only 40% of the patients for the year
Survey period Sample (n) Overweight Obese Extremely obese
Percent (standard error)
1988–1994 16,235 33.1 (0.6) 22.9 (0.7) 2.8 (0.2)
1999–2000 4,117 34.0 (1.0) 30.5 (1.5) 4.7 (0.6)
2001–2002 4,413 35.1 (1.1) 30.5 (1.1) 5.1 (0.5)
2003–2004 4,431 34.1 (1.1) 32.2 (1.2) 4.8 (0.6)
2005–2006 4,356 32.6 (0.8) 34.3 (1.4) 5.9 (0.5)
2007–2008 5,550 34.3 (0.8) 33.7 (1.1) 5.7 (0.4)
2009–2010 5,926 33.0 (1.0) 35.7 (0.9) 6.3 (0.2)
2011–2012 5,181 33.6 (1.3) 34.9 (1.4) 6.4 (0.6)
28. Prove Value Quickly
We designed specialty tools in the Epic EMR to not just remind physicians to
address morbid obesity (HCC was worth $2900 in 2013), but also remember to
address all HCCs.
For those of you on Epic, you can view our past UGM presentation and we can
share our coding.
29. Growing the Team
With the improved capture rate of HCCs, we easily proved our value and secured
funding for full-time employees
We recruited the most creative and best critical thinkers from around the country.
• Ability to look at problems in unconventional ways
• Ability to generate new and useful ideas
• Ability to analyze which ideas are worth pursuing and which are not
• Ability to articulate new ideas to others and convince others that ideas are worth pursuing
• Possess a tolerance for ambiguity and willingness to overcome obstacles
• Possess a willingness to take reasonable risks
• Self Starter
30. Growing the Team
Lesson learned:
There is a lot of interest in the organization to join the team, however it is
sometimes difficult to find the right people.
Many people want to join to do something different, rather than make a difference.
We need passionate, driven team members to tackle these seemingly impossible
issues
31. Focus on Chronic Disease Management
Focus in 2014 and 2015 is chronic disease management
Using the newest technologies available, target the 65% of contributing factors we
have control over – not just 10%
40%
15%
30%
5%
10%
32. Prioritizing Diseases
Inpatient Readmissions - CHF
Elixhauser A (AHRQ), Steiner C (AHRQ). Readmissions to U.S. Hospitals by Diagnosis, 2010. HCUP Statistical Brief #153. April
2013. Agency for Healthcare Research and Quality, Rockville, MD.
26.1 25.7
24.2
0
5
10
15
20
25
30
18-44 45-64 65+
All-cause 30-day readmission rates for
congestive heart failure
Age
33. Prioritizing Diseases
Outpatient diagnoses - Hypertension
Chronic Condition % of outpatient visits
Hypertension 27.0
Hyperlipidemia 15.7
Diabetes 15.1
Depression 12.4
Arthritis 10.2
SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
34. Congestive Heart Failure
Targeted approach for all heart failure
patients including detailed screening
(i.e. depression, med adherence, etc.)
with dedicated HF nurses.
Comprehensive OP monitoring with
HF care team
Monitors daily weight for changes and
reaches out to patient to provide real-
time guidance and treatment.
36. Level 2: Assessments
Affordability of meds
Medication adherence
Drug-drug, drug-condition interactions
HF Quality of Life
Depression screen
Family / Caregiver support
Transportation issues
Education level / level of HF understanding
Alcohol / drug use
Dietary sodium quantification
In-depth evaluation and quantification of patient specific characteristics
37. Level 2: Interactive Assessments
Everything is completed on Windows tablets using Welcome!
Patient scores high on sodium consumption
• “Who shops for your groceries”?
• “Who prepares your meals”?
Patient views video on what high sodium
means and why it is important; shown what
foods are high in sodium and which foods
make better choices
Individual(s) who shops for and prepares
meals sent email with literature and video
link
38. Level 2: Inpatient Intervention
Pharmacy consulted for adherence/affordability
(+/- social worker). If unaffordable, 30-day supply
of meds provided at discharge.
Psychiatry consulted for depression, drug/alcohol
addiction.
Nutrition consulted for high dietary sodium intake.
Social services for transportation, caregiver
support, home health services.
Educated in heart failure disease state; use of
monitoring scale; cause and effect relationships.
39. Level 3: Outpatient home monitoring
metrics
scrubbed
thru
condition
specific
algorithms
patients
stratified
by risk
status
high risk
patients
intervened
by
medication
adjustment
and/or
outpatient
visit
X
potential
readmission
avoided
40. RelationshipbetweenImproved Care Coordination andReadmission in
HeartFailurePatients
0
5
10
15
20
25
30
35
40
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan
%Readmissions
2012 2013 2014
14%
25%
Program
41. Hypertension
Hypertension is the most common diagnosis made at primary care office visits.
Most common chronic condition, affecting about 30% of US adults, with estimated
annual costs > $50 billion.
Only half of patients with hypertension achieve BP control; the leading cause of
which is “therapeutic inertia” (86.9%).
Ranking Prevalence State
47 39.8% LA
48 40.2% MS
49 40.3% AL
50 41.0% W.Va
Roger VL, et al. Circulation. 2012;125(1):e2-e220.
Hsiao C, et al. National Ambulatory Medical Care Survey: 2007 Summary. Hyattsville, MD: National Center for Health Statiastics; 2010.
Margolis KL. JAMA 2013;310(1): 46-56.
Milani RV, et al. J Am Coll Cardiol 2013;62:2185-7.
42. Just as banking can be done outside the confines of a bank,
BP monitoring and management can and should be done at
home and in other nonclinical settings such as pharmacies
and community and senior centers. Out-of-clinic BP
monitoring with team care should largely replace
traditional office-based BP management for most patients.
Absent a contraindication to home monitoring, patients
should be provided with a validated BP monitor and BP
measurements should be transmitted to each patient’s
clinician, with follow-up patient-clinician communication
by telephone or by electronic visits, if necessary. If home
BP monitoring and team-based care were implemented
broadly, hypertension management would be easier for
patients, and the magnitude of BP reductions brought about
by this change could lead to substantial reductions in
cardiovascular events and mortality, which is something
patients, clinicians, and policy makers can take to the bank.
43. Home BP Telemonitoring: HyperLink Study
Proportion of Patients with Controlled Blood Pressure
Follow-up Telemonitoring Usual Care p-value
6 months 71.8% 45.2% <0.001
12 months 71.2% 52.8% 0.001
18 months 71.8% 57.1% 0.003
Margolis KL. JAMA 2013;310(1): 46-56.
44. Innovative Model for Care Delivery Going Forward
1. Utilizes non-physician providers of care that supports
physicians
2. Works in a “focused-factory” that can keep up with an ever
expanding knowledge-base and growing set of quality
measures
3. Assess, characterize, and potentially modify social
circumstances and behavioral patterns to enhance overall
health status
4. Exploit technology to its fullest in order to manage large
populations of patients efficiently (i.e. decision-support tools)
5. Monitor and “touch” patients remotely (just-in-time) resulting
in faster cycle-times for meeting goals and enhanced patient
satisfaction
45. Apple HealthKit, Withings, Fitbit
In October 2014, Ochsner integrated
HealthKit with our Epic EMR
HealthKit now provides a standardized
platform for a variety of in-home
devices
We can concentrate on the largest few
manufacturers for Android users
Withings
Fitbit
46. Overall lessons learned
Senior executive support
Integration into operations and IT is crucial to the long term success and
maintainability of our programs
Cannot maintain dozens of incoming patient entered data streams
Take your time and choose the right team
Ability to quickly get data from EMR – can’t rely on standard reporting processes for
quick reports
Fail fast
47. What’s next?
Expand Chronic Disease Management programs
Conduct analysis on why 65% of readmissions aren’t
from the admission dx
Research new wearables and integration of more
areas of the home